Hospital outpatient billing in a provider-based setting can be very nuanced and complicated. In provider-based billing – the main provider is the hospital, which in turn is responsible for ownership and operation of another location to provide additional healthcare services. These hospital outpatient clinics are subject to stricter government regulations because the patients are essentially being treated by the hospital either on-campus or off-campus. Provider-based billing requires qualified and competent revenue cycle management to ensure that providers are correctly identified and eligible for provider-based status and are also appropriately reimbursed. Provider-based billing models can be tedious and confusing, requiring competent oversight and training to ensure compliance with these stringent Medicare rules. Physician supervision requirements vary depending on the type of services being provided as well as the location of the service.
In this webinar, our expert speaker will discuss the physician supervision requirements for diagnostic services and therapeutic services, the rules for on-campus vs. off-campus departments as well as the different types of physician supervision – general, direct, and personal required for each setting.
Toni Elhoms is an internationally known speaker and recognized subject matter expert on medical coding, reimbursement, compliance, and revenue cycle management. She is the Founder and CEO of Alpha Coding Experts, LLC (ACE). She holds multiple credentials with the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC). Ms. Elhoms’ expertise extends to both inpatient and outpatient coding, compliance, billing, and reimbursement. Ms. Elhoms serves as ACE’s Senior Consultant and conducts training and educational seminars across the country on a variety of topics including, but not limited to, Medical Coding, Medical Billing, Practice Management, Managed Care, Revenue Cycle Management, Revenue Maximization, Regulatory Compliance, etc.